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Altered states of consciousness refer to qualitative shifts in an individual's overall pattern of mental functioning. This article presents the 3-part development and validation of a multidimensional self-report measure of autonomous sensory meridian response (ASMR). ASMR is an intensely pleasurable, head-orientated tingling sensation that typically occurs in response to specific, audiovisual triggers, producing feelings of comfort, relaxation and euphoria. A mixed-methods approach was adopted, conducting a content analysis on 303 accounts of ASMR, to derive a comprehensive self-report measure. Exploratory (n ϭ 453; n ϭ 448) and confirmatory analyses (n ϭ 448) were utilized to determine the underlying factor structure of the ASMR measure and replicability of findings across assessment applications. Convergent and divergent validity were assessed through comparisons with other, established alterations of consciousness, including frisson, absorption, alexithymia, flow, misophonia and anxiety. The resultant ASMR-15 demonstrated sufficient internal consistency (␣ ϭ .78) and validity as a measure of ASMR propensity, and may be useful to researchers interested in further exploring and disentangling ASMR from other alterations of consciousness.

Autonomous sensory meridian response (ASMR) is a multidimensional sensoryaffective experience typically described as a head-oriented tingling sensation that occurs upon exposure to specific audiovisual triggers. Previous work using a 15-item multidimensional measure of ASMR propensity (Autonomous Sensory Meridian Response Scale [ASMR-15]), with sensory, affective, relaxation, and altered consciousness subscales, established the relationships between openness, absorption, and ASMR. However, the altered consciousness dimension of ASMR experiences remains relatively unexplored. As a result, this article explores the relationships between ASMR and a number of constructs associated with alterations in consciousness. Additional aims of the study were to assess the replicability of the established four factor structure of the modified ASMR-15, when administered to online interest group samples, and to explore the relationships between common ASMR trigger preferences and dimensions of ASMR propensity. To achieve this, the ASMR-15 was administered to participants from Facebook (n ϭ 201) and Reddit (n ϭ 256) ASMR interest groups, alongside measures of transliminality (Revised Transliminality Scale), unusual experiences (Unusual Experiences subscale), mindfulness (Mindful Attention and Awareness Scale), and body consciousness (Private Body Consciousness subscale). Additional items assessed participants' stimulus preferences from a list of common ASMR triggers, with an opportunity for the nomination of additional triggers, via free response. Through quantitative analyses, and categorization of qualitative responses, significant variation in preferences was observed across the sample. Correlational analyses indicated convergence between ASMR, transliminality, body consciousness, and unusual experiences, and divergence between the ASMR-15 and mindfulness scores. These findings open new avenues of ASMR exploration in relation to consciousness, specifically whether ASMR may be an altered state experience facilitated by thinner psychological boundaries.

We identified factors associated with a response in abdominal pain to placebo using original data from an IBS clinical trial. Baseline factors associated with the placebo response in women with IBS and constipation included variation in baseline pain symptoms, severity of baseline symptoms, and early improvement of abdominal pain. These findings have significant implications for clinical trial design.

STUDY QUESTION What is the relationship between specific quality of life domains and depression, anxiety and stress in the endometriosis population? SUMMARY ANSWER Psychosocial domains of quality of life, such as a perception of social support and self-image, are more strongly associated with depression, anxiety and stress than pain and medical factors. WHAT IS KNOWN ALREADY Prior research indicates a high prevalence of anxiety and depression in individuals with endometriosis. Pain is thought to be critical in the development of psychological distress, however prior research has investigated this association without consideration of psychosocial quality of life domains such as social functioning, perceived social support and self-image. STUDY DESIGN, SIZE, DURATION This study is a cross-sectional analysis of baseline data collected in a longitudinal study exploring psychological distress in endometriosis (n = 584). PARTICIPANTS/MATERIALS, SETTING, METHODS Individuals living with endometriosis participated in this study and were recruited via online platforms of community organizations and support groups. Demographic and medical information concerning endometriosis treatment and diagnosis was self-reported. Psychological distress and quality of life was measured using the Depression, Anxiety and Stress Scale (DASS-21), Endometriosis Health Profile-30 (EHP-30) and the Short Form Survey (SF-36v2). A series of linear regression analyses explored the relationship between specific quality of life domains and the primary outcomes of depression, anxiety and stress. MAIN RESULTS AND THE ROLE OF CHANCE Approximately half of the participants in this sample reported moderate to severe anxiety, depression and stress. Quality of life domains, particularly perceived social support, social functioning and self-image, were more strongly associated with psychological distress than medical or demographic factors. Pain was associated with anxiety, but not depression or stress. A greater number of endometriosis symptoms was only associated with depression. LIMITATIONS, REASONS FOR CAUTION These data are cross-sectional and, therefore, causality cannot be inferred from this analysis. Information about endometriosis diagnosis and treatment was self-reported, and not verified against medical records. WIDER IMPLICATIONS OF THE FINDINGS This study indicates that psychosocial factors may be more salient factors underlying depression, anxiety and stress in the endometriosis population than pain and medical factors. There is a need for interventions that target psychological distress in this population with a focus on the broader impact of endometriosis beyond pain and physical symptomatology. STUDY FUNDING/COMPETING INTEREST(S) This research was supported by the Research Training Program (RTP) Scholarship awarded to C.S.M. by Macquarie University. The remaining authors have nothing to declare. TRIAL REGISTRATION NUMBER ACTRN12619001508167.

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